The federal government is rolling out new flexibilities aimed at supporting providers as the fallout from the Change Healthcare cyberattack continues, but industry groups say the steps aren't enough to mitigate the challenges they're facing.
The Department of Health and Human Services (HHS) said Tuesday afternoon that the Centers for Medicare & Medicaid Services (CMS) will be taking the lead on the response. CMS will issue guidance encouraging Medicare Advantage and Part D plans to relax utilization management requirements and to offer advance payments to providers who may be most impacted by ongoing outages.
The agency is urging that states take similar steps in Medicaid and the Children's Health Insurance Program (CHIP), according to an announcement.
"HHS is in regular contact with [UnitedHealth Group] leadership, state partners, and with numerous external stakeholders to better understand the nature of the impacts and to ensure the effectiveness of UHG’s response," the agency said in a statement. "HHS has made clear its expectation that UHG does everything in its power to ensure continuity of operations for all health care providers impacted and HHS appreciates UHG’s continuous efforts to do so."
The cybersecurity issue was first revealed on Feb. 21, and disruptions have continued since then, with providers across the country struggling to get paid. UnitedHealth Group, the parent company of Change, confirmed that its systems were breached by a cybercriminal gang known as BlackCat or ALPHV.
HHS said that providers in the Medicare program should reach out to a Medicare Administrative Contractor (MAC) if they need to switch to a new clearinghouse during the disruption. The MAC can provide a new electronic data interchange enrollment, and CMS has instructed these contractors to expedite the process. It's calling on Medicaid and CHIP programs to take similar steps, according to the announcement.
CMS has also reached out to Medicare contractors to prepare them to accept paper claims from providers who need to use that method for the time being. Providers that are struggling to fill out claims should contact their MAC for assistance with any waivers or other respite programs.
The agency also said that MACs would make information available later this week on accelerated payments for providers and encouraged them to take advantage of these offerings from private payers and the feds.
However, major provider groups said the support offerings fall short of what they were seeking as the cyberattack drags on. Rick Pollack, president of the American Hospital Association, said in a statement that the organization would continue working with legislators to find "meaningful solutions" to keep the healthcare system up and running.
"We cannot say this more clearly—the Change Healthcare cyberattack is the most significant and consequential incident of its kind against the U.S. health care system in history," Pollack said. "For nearly two weeks, this attack has made it harder for hospitals to provide patient care, fill prescriptions, submit insurance claims, and receive payment for the essential health care services they provide."
"The magnitude of this moment deserves the same level of urgency and leadership our government has deployed to any national event of this scale before it," Pollack said. "The measures announced today do not do that and are not an adequate whole of government response."
Jesse Ehrenfeld, M.D., president of the American Medical Association, gave HHS credit for stepping in but called the new flexibilities a "welcome first step, but we urge CMS to recognize that physicians are experiencing financial struggles that threaten the viability of many medical practices."
"Many physician practices operate on thin margins, and we are especially concerned about the impact on small and/or rural practices, as well as those that care for the underserved," Ehrenfeld said in a statement. "The AMA urges federal officials to go above and beyond what has been put in place and include financial assistance such as advanced payments for physicians."